| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.88 | $58.88 | $58.88 | |
Aetna
| Professional | $40.74 | $56.23 | $64.57 | |
Cigna
| Professional | $89.13 | $89.13 | $89.13 | |
Kaiser Permanente
| Professional | $61.66 | $64.57 | $128.82 | |
United
| Facility | $389.05 | $457.09 | $537.03 | |
United
| Professional | $42.66 | $107.15 | $162.18 |